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1.
J Recept Signal Transduct Res ; 28(4): 403-12, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18702011

RESUMEN

We compared the effects of two alpha(1)-adrenoceptor antagonists with different selectivity for the alpha(1)-adrenoceptor subtypes, prazosin and naftopidil, on pelvic blood flow and nitric oxide synthase (NOS) levels in the spontaneously hypertensive rat (SHR). SHRs and normotensive Wistar-Kyoto (WKY) rats were distributed initially in four groups: group 1 received prazosin, a subtype nonselective alpha(1)-adrenoceptor antagonist (2 mg/kg/day); group 2 received naftopidil, a selective alpha(1A/D)-adrenoceptor antagonist (10 mg/kg/day); group 3 received cyclazosin, a selective alpha(1B)-adrenoceptor antagonist (5 mg/kg/day); and group 4 received the vehicle orally for 4 weeks. Pelvic blood flow was determined by using a fluorescent microsphere infusion technique. Expression levels of nNOS and eNOS mRNAs in the rat genitourinary tissues were quantified by real-time reverse transcription polymerase chain reaction (RT-PCR) using SYBR Green I. The characteristics of alpha(1)-adrenoceptors in the rat iliac artery were determined by using radioligand receptor binding and real-time RT-PCR techniques. Untreated SHRs had lower blood flow to the ventral prostate, dorsolateral prostate, urinary bladder, and penis and lower mRNA expression levels of nNOS in the bladder and penis and eNOS in the penis than untreated WKY rats. Naftopidil had no significant effects on blood flow and NOS levels, whereas administration of prazosin and cyclazosin to the SHR caused a significant increase in blood flow to each tissue studied and a significant increase in expression levels of these genes. The density of total alpha(1)-adrenoceptors was significantly higher in iliac arteries of untreated SHRs than those of untreated WKY rats. RT-PCR data indicated that alpha(1B)-adrenoceptor mRNA was the significantly predominant gene transcript in iliac arteries of untreated SHRs. Our data show that prazosin, but not naftopidil, causes differential alterations in NOS levels in the SHR genitourinary tract, which could be due to increased pelvic blood flow resulting from inhibiting the vascular alpha(1B)-adrenoceptor. These findings may provide insight into the beneficial effects of subtype nonselective alpha(1)-adrenoceptor antagonists on prostate, bladder, and penile function, when used to treat symptoms of benign prostatic hyperplasia and elevated blood pressure.


Asunto(s)
Hipertensión/fisiopatología , Naftalenos/farmacología , Óxido Nítrico Sintasa/metabolismo , Pelvis/irrigación sanguínea , Pene/irrigación sanguínea , Piperazinas/farmacología , Prazosina/farmacología , Próstata/irrigación sanguínea , Receptores Adrenérgicos alfa/metabolismo , Vejiga Urinaria/irrigación sanguínea , Antagonistas Adrenérgicos alfa/administración & dosificación , Antagonistas Adrenérgicos alfa/farmacología , Animales , Hipertensión/enzimología , Masculino , Naftalenos/administración & dosificación , Pene/efectos de los fármacos , Piperazinas/administración & dosificación , Prazosina/administración & dosificación , Próstata/efectos de los fármacos , Quinazolinas/administración & dosificación , Quinazolinas/farmacología , Quinoxalinas/administración & dosificación , Quinoxalinas/farmacología , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Flujo Sanguíneo Regional/efectos de los fármacos , Vejiga Urinaria/efectos de los fármacos
2.
Acupunct Med ; 26(2): 79-86, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18591907

RESUMEN

OBJECTIVES: To investigate whether acupuncture stimulation affects autonomic nerve function by measuring pupil diameters with electronic pupillography. METHODS: Two studies were conducted (Experiment 1 and 2) in the Tsukuba University of Technology, Tsukuba, Japan. Experiment 1 examined the responses before, during and after acupuncture. Experiment 2 compared acupuncture and a no acupuncture control in a two period, repeated measurement crossover design. Twelve healthy male university students were recruited for Experiment 1 and nine healthy male university students for Experiment 2. The intervention was superficial acupuncture at the acupuncture point TE5. Following the insertion, gentle repetitive tapping stimulation was applied during the subject's exhalation phase in a sitting position for 90 seconds. The main outcome measures in Experiment 1 were pupil diameter, heart rate, pulse wave and blood pressure. In both experiments, pupil diameter was measured for three minutes before acupuncture stimulation, during stimulation and for three minutes after stimulation. RESULTS: In Experiment 1, a decrease in pupil diameter was observed after acupuncture stimulation (P=0.018) and a decrease in heart rate was observed during the stimulation (P=0.049). Moreover, a significant decrease of pulse wave amplitude was observed during and after acupuncture stimulation. In Experiment 2, a decrease in pupil diameter occurred after acupuncture stimulation (P=0.007), whereas no change occurred under the no acupuncture control. CONCLUSIONS: It is thought that the pupillary constriction observed after gentle, superficial acupuncture stimulation may be attributed to an increase of parasympathetic nerve function. Further study is necessary in order to further clarify the duration of the observed response and to elucidate the mechanisms behind it.


Asunto(s)
Acupuntura , Reflejo Pupilar/fisiología , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Sistema Nervioso Parasimpático/fisiología , Adulto Joven
3.
Pharmacology ; 82(1): 43-52, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18434763

RESUMEN

To investigate the effects of solifenacin on human detrusor smooth muscles, we evaluate the effects of solifenacin on the contractions induced by carbachol, KCl, CaCl2 and electrical field stimulation (EFS), and the EFS-induced acetylcholine release from detrusor smooth muscle strips by using the muscle bath and microdialysis technique. The effects of solifenacin were also compared with effects of other antimuscarinic agents (atropine, oxybutynin and propiverine). Pretreatment with various antimuscarinic agents caused parallel shifts to the right of the concentration-response curves to carbachol. The pA2 value of the Schild plots for solifenacin was similar to that for oxybutynin. Atropine did not inhibit the KCl- and CaCl2-induced contractions, while solifenacin, oxybutynin and propiverine significantly inhibited these contractions. EFS-induced contractions were inhibited by various antimuscarinic drugs in a concentration-dependent manner. In the presence of atropine, solifenacin tended to inhibit the residual atropine-resistant contractions induced by EFS, but it was not significant. However, oxybutynin and propiverine inhibited them under the same conditions. Although pretreatment with atropine and propiverine did not cause significant changes in EFS-induced acetylcholine release, solifenacin and oxybutynin caused significant decreases in acetylcholine release. The present results suggest that solifenacin inhibits contractions of human detrusor smooth muscles mainly by the antimuscarinic action and that the high concentration of solifenacin has Ca2+ channel antagonist action. Moreover, solifenacin may block not only postjunctional receptors, but also prejunctional receptors to modulate acetylcholine releases in cholinergic nerve endings in human detrusor smooth muscles. The findings support that muscarinic-receptor-inhibitory actions in human bladder mainly contribute to the usefulness of solifenacin as a therapeutic drug for overactive bladder.


Asunto(s)
Antagonistas Muscarínicos/farmacología , Quinuclidinas/farmacología , Tetrahidroisoquinolinas/farmacología , Vejiga Urinaria/efectos de los fármacos , Anciano , Cloruro de Calcio/farmacología , Carbacol/farmacología , Relación Dosis-Respuesta a Droga , Estimulación Eléctrica , Femenino , Humanos , Técnicas In Vitro , Masculino , Microdiálisis , Contracción Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Músculo Liso/fisiología , Cloruro de Potasio/farmacología , Succinato de Solifenacina , Vejiga Urinaria/fisiología
4.
Int J Urol ; 15(2): 166-70, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-18269457

RESUMEN

OBJECTIVES: The present study investigated the expression of acyl-coenzyme A: cholesterol acyltransferase-1 (ACAT-1) and -2 in clear cell type renal cell carcinoma (RCC). METHODS: Clear cell type RCC and corresponding normal kidney tissue samples were obtained from 19 surgical cases (28-85 years of age). Tissue extracts were assayed for ACAT activity and protein expression by immunoblotting with anti-ACAT-1 and anti-ACAT-2 antibodies. Frozen sections were subjected to Oil red O staining for lipids, and were immunostained with ACAT-specific antibodies. RESULTS: Acyl-coenzyme A cholesterol acyltransferase activity was 5.7-fold higher (P < 0.01) in clear cell carcinoma (23.52 +/- 4.90 pmol/mg protein/min) than in normal kidney (4.12 +/- 0.36). Consistent with this, immunoblotting and immunohistochemical staining revealed strong expression of ACAT-1 in clear cell type RCC. Densitometric analysis showed that ACAT-1 expression was 2.9-fold higher in clear cell type RCC than in normal kidney. In contrast, ACAT-2 expression was negative in clear cell type RCC and normal kidney. Oil red O staining showed massive deposits of lipid in RCC cells. CONCLUSIONS: We identified strong expression of ACAT-1 in clear cell type RCC. Upregulation of ACAT-1 leads to high ACAT enzymatic activity, which accelerates the accumulation of cholesterol ester in clear cell type RCC.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Carcinoma de Células Renales/enzimología , Neoplasias Renales/enzimología , Esterol O-Aciltransferasa/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos , Femenino , Humanos , Immunoblotting , Inmunohistoquímica , Isoenzimas/metabolismo , Masculino , Persona de Mediana Edad , Esterol O-Aciltransferasa/inmunología
5.
Nihon Hinyokika Gakkai Zasshi ; 99(1): 48-51, 2008 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-18260349

RESUMEN

Calcifying fibrous (pseudo) tumour (CFP) is an uncommon and distinct pathological entity, which is usually occurring in the soft tissue of the extremities, trunk, axilla, pleura, mediastinum and peritoneum. We report a case of CFP of the adrenal gland. A 29-years-old previously healthy woman complained the left lumbago. A solid mass was found on computed tomography on the left adrenal gland. There were no abnormalities in physical examination and laboratory studies. Only urinary noradrenalines and dopamines levels were slightly high. Laparoscopic left adrenalectomy was performed. Pathological findings of the left adrenal tumor showed dense hyalinized fibrous tissue containing bland spindle-shaped cells, calcifications, and lymphoplasmacytic infiltrate. Our case seems to be the first case of CFP to be published in the Japanese literature.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/cirugía , Calcinosis/cirugía , Granuloma de Células Plasmáticas/cirugía , Neoplasias de Tejido Muscular/cirugía , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Adrenalectomía , Adulto , Calcinosis/diagnóstico , Calcinosis/patología , Femenino , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/patología , Humanos , Laparoscopía , Imagen por Resonancia Magnética , Neoplasias de Tejido Muscular/diagnóstico , Neoplasias de Tejido Muscular/patología , Tomografía Computarizada por Rayos X
6.
Int J Urol ; 15(1): 76-81, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18184179

RESUMEN

OBJECTIVE: To investigate the effects of M-1, a major active metabolite of propiverine on the bladder. METHODS: We have evaluated the effects of M-1 on the contractions induced by carbachol, KCl, CaCl(2), and electrical field stimulation (EFS) in human detrusor smooth muscles, and pelvic nerve stimulation-induced bladder contractions in rats. The effects of M-1 were also compared with the effects of propiverine and tolterodine. RESULTS: Pretreatment with propiverine and tolterodine caused parallel shifts to the right of the concentration-response curves to carbachol. M-1 caused concentration-dependent reduction in the maximum contractile responses induced by carbachol. Although tolterodine did not inhibit the KCl- and CaCl(2)-induced contractions, M-1 and propiverine significantly inhibited these contractions. In the presence of atropine, M-1 and propiverine significantly inhibited the atropine resistant part of the contraction induced by EFS. On the other hand, tolterodine did not have significant inhibitory effects on atropine resistant contractions. Pelvic nerve stimulation induced bimodal phasic and tonic contractions in the rat bladder. M-1 mainly inhibited the phasic contraction. Tolterodine caused a significant inhibition in the tonic contraction, and propiverine had inhibitory effects on both contractions. CONCLUSIONS: The present results suggest that M-1 has inhibitory effects on the bladder smooth muscles through calcium antagonistic action. It is possible that the clinical effects of propiverine on the human bladder are based not only on the action of propiverine itself but also on one of its active metabolites, M-1.


Asunto(s)
Bencilatos/farmacología , Óxidos N-Cíclicos/farmacología , Contracción Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Parasimpatolíticos/farmacología , Vejiga Urinaria/efectos de los fármacos , Anciano , Animales , Compuestos de Bencidrilo/farmacología , Carbacol , Agonistas Colinérgicos , Cresoles/farmacología , Femenino , Humanos , Modelos Animales , Antagonistas Muscarínicos/farmacología , Fenilpropanolamina/farmacología , Ratas , Ratas Wistar , Tartrato de Tolterodina
7.
BJU Int ; 101(5): 633-9, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18070174

RESUMEN

OBJECTIVE: To investigate changes in acetylcholine release from the bladder of rats with partial bladder outlet obstruction (BOO), as partial BOO leads to hypertrophy and an alteration in the contractions of the detrusor smooth muscle, and acetylcholine plays an important role in urinary bladder contractions but there is little available information on acetylcholine release after BOO. MATERIAL AND METHODS: Partial BOO was induced in adult female rats by ligating the proximal urethra over a 1 mm angiocatheter; sham-operated rats served as controls. The rats were killed 2 weeks, 3 and 6 months after induction of BOO. We investigated the contractions induced by carbachol, KCl (80 mm), ATP and electrical-field stimulation (EFS, 2.5-40 Hz), and collected the dialysate obtained from a microdialysis probe inserted into the muscle strips during EFS, and measured the amount of acetylcholine in the dialysate fraction by high-performance liquid chromatography with electro-chemical detection. S-100 immunohistochemical staining of the bladder preparations was used for histological examination in BOO and control rats. RESULTS: The bladder weight gradually increased after BOO. There were no significant changes in KCl-induced contractions throughout the experimental period in either group. There were no significant changes in carbachol-induced contractions until 3 months after BOO but there was a significant reduction at 6 months. ATP-induced contractions were significantly increased 2 weeks and 3 months after BOO. EFS-induced contractions were gradually reduced after BOO. Acetylcholine release from the bladder strips was not significantly different between the groups until 2 weeks after BOO. However, acetylcholine release in BOO rats was significantly decreased 3-6 months after BOO, being significantly lower than that of the control rats. In the histological study, the number of nerve fibres in the BOO rats was significantly lower than in the control rats. CONCLUSIONS: We suggest that the prolonged BOO caused a decrease in EFS-induced acetylcholine release and the number of nerves in the rat urinary bladder, which might contribute to bladder underactivity in BOO.


Asunto(s)
Acetilcolina/metabolismo , Contracción Muscular/fisiología , Obstrucción del Cuello de la Vejiga Urinaria/metabolismo , Vejiga Urinaria/metabolismo , Animales , Cromatografía Líquida de Alta Presión , Femenino , Inmunohistoquímica , Músculo Liso/metabolismo , Músculo Liso/fisiología , Ratas , Ratas Sprague-Dawley , Vejiga Urinaria/inervación , Vejiga Urinaria/fisiopatología , Obstrucción del Cuello de la Vejiga Urinaria/fisiopatología
8.
Cancer Chemother Pharmacol ; 61(1): 53-61, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17375305

RESUMEN

PURPOSE: Advanced prostate cancer, which is one of the most common cancers, usually progresses to hormone-refractory prostate cancer (HRPC). A recent randomized trial of treatment with docetaxel demonstrated improved survival for patients with HRPC. The combination of docetaxel and estramustine phosphate (estramustine) has been reported to be effective for HRPC. Low-dose estramustine suppresses the pituitary-gonadal axis. Docetaxel plus 5-fluoro-5'-deoxyuridine (5'-dFUrd) had supra-additive cytotoxic effects on HRPC cells consistent with the molecular mechanism. Therefore, we examined the efficacy of adding 5'-dFUrd on the chemotherapy regimen, which consist docetaxel and estramustine. METHODS: All of the HRPC patients were treated with estramustine 140 mg orally twice 5'-dFUrd 200 mg orally four times daily on days 1-21, and docetaxel 60 mg/m(2) was administered on day 1. We evaluated serum prostate-specific antigen (PSA) and measurable responses, the progression-free and overall survival, and the impact on adverse effects and the quality of life (QOL). RESULTS: Of 34 patients with a median age of 72.3 years, 73% showed PSA responses and 70% showed measurable responses. The median progression-free survival was 18.0 and 5.8 months for PSA responders and non-responders and the overall survival was 19.4 months, respectively. There were few serious adverse effects. Grade 3/4 neutropenia occurred in 32.4% of the patients, and was easily managed with granulocyte colony-stimulating factor (G-CSF) injection. There was no significant change in the overall QOL scores serially. CONCLUSIONS: This study shows that the combined regimen is tolerable and effective in Japanese HRPC patients.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antígeno Prostático Específico/efectos de los fármacos , Neoplasias de la Próstata/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Progresión de la Enfermedad , Docetaxel , Estramustina/administración & dosificación , Floxuridina/administración & dosificación , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Humanos , Japón , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Calidad de Vida , Tasa de Supervivencia , Taxoides/administración & dosificación
9.
Nihon Hinyokika Gakkai Zasshi ; 98(7): 843-7, 2007 Nov.
Artículo en Japonés | MEDLINE | ID: mdl-18062217

RESUMEN

A case of bilateral pheochromocytomas with von Hippel Lindau disease (VHL) is reported. A 32-year-old man visited Kumamoto Red Cross Hospital for further examination of hypertension. Computed tomography revealed bilateral adrenal tumors and noradrenalin levels in serum and urine were elevated. Suspecting bilateral pheochromocytoma, he was reffered to our hospital for further examination and treatment. 131I-MIBG scintigraphy showed accumulation in bilateral adrenal glands. Moreover, he had cerebellar and spinal hemangioblastomas. Bilateral adrenalectomies and left nephrectomy were performed because tumor thrombus extended into the left renal vein, and pathological diagnosis was pheochromocytoma. His sister had been diagnosed as VHL disease. We diagnosed the patient as VHL disease because of the existence of cerebellar and spinal hemangioblastomas, bilateral pheochromocytomas, missense mutation and his family history. This is the eleventh case of bilateral pheochromocytomas with VHL disease reported in Japanese literatures.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/complicaciones , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Feocromocitoma/complicaciones , Enfermedad de von Hippel-Lindau/complicaciones , Enfermedad de von Hippel-Lindau/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía , Adulto , Diagnóstico por Imagen , Femenino , Humanos , Masculino , Mutación Missense , Feocromocitoma/diagnóstico , Feocromocitoma/patología , Feocromocitoma/cirugía , Hermanos , Enfermedad de von Hippel-Lindau/genética
10.
Life Sci ; 81(3): 218-22, 2007 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-17574276

RESUMEN

Hypertension may impact pelvic arterial blood flow resulting in reduction of nitric oxide synthase (NOS) levels. Although doxazosin, an alpha(1)-adrenoceptor antagonist, has been shown to improve erectile dysfunction as well as benign prostatic hyperplasia (BPH) and hypertension, it is not clear whether these improvements using doxazosin are primarily due to direct actions on the prostate, urinary bladder and penis, possibly via inhibition of vascular alpha(1)-adrenoceptors, or other sites of actions. Therefore, we investigated effects of doxazosin to the spontaneously hypertensive rat (SHR) on blood flow and NOS levels in the genitourinary tract. Four groups of rats were assessed: group 1, SHRs treated with doxazosin (30 mg/kg/day) for 4 weeks; group 2, SHRs treated with nifedipine (30 mg/kg/day) for 4 weeks; group 3, untreated SHRs; and group 4, untreated Wistar-Kyoto (WKY) rats. Blood flow to the ventral prostate, dorsolateral prostate, urinary bladder and penis was determined using a fluorescent microsphere infusion technique. Expression levels of nNOS and eNOS mRNAs were quantified by real-time RT-PCR using SYBR Green I. Blood flow to the ventral prostate, dorsolateral prostate, urinary bladder and penis was significantly lower in untreated SHRs than WKY rats. Treatment with doxazosin increased blood flow to each tissue studied in SHRs. RT-PCR data indicated that untreated SHRs had lower mRNA expression levels of nNOS in the bladder and penis and eNOS in the penis than WKY rats and that administration of doxazosin to the SHR caused an increase in expression levels of these genes, i.e., up-regulation of nNOS in the bladder and penis and eNOS in the penis. However, nifedipine had no significant effects on blood flow and NOS levels in the SHR genitourinary tract. Our data demonstrate that doxazosin treatment causes differential alterations in blood flow and NOS levels in the SHR genitourinary tract. These findings may provide insight into the beneficial effects of alpha(1)-adrenoceptor antagonists, on prostate, bladder and penile function, when used to treat symptoms of BPH and elevated blood pressure.


Asunto(s)
Antagonistas Adrenérgicos alfa/farmacología , Doxazosina/farmacología , Óxido Nítrico Sintasa/biosíntesis , ARN Mensajero/genética , Sistema Urogenital/metabolismo , Animales , Interpretación Estadística de Datos , Colorantes Fluorescentes , Masculino , Microesferas , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Flujo Sanguíneo Regional/efectos de los fármacos , Sistema Urogenital/irrigación sanguínea , Sistema Urogenital/efectos de los fármacos
11.
Cancer Immunol Immunother ; 56(8): 1173-82, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17186290

RESUMEN

PURPOSE: The programmed death-1 (PD-1)/B7-H1 (also called PD-L1) pathway negatively regulates T cell activation and has been suggested to play an important role in regulating antitumor host immunity. To investigate the clinical significance of B7-H1 expression to the tumor grade and postoperative prognosis of patients with urothelial cancer, we analyzed the relationship between B7-H1 expression and various clinicopathological features and postoperative prognosis. EXPERIMENTAL DESIGN: Sixty-five urothelial cancer cases were examined. B7-H1 expression in tumors and the numbers and phenotypes of tumor-infiltrating lymphocytes were evaluated by immunohistochemistry and flow cytometry. RESULTS: A substantial expression of B7-H1 was observed in all urothelial cancers investigated. Tumor specimens from patients with higher WHO grade or primary tumor classifications showed significantly higher percentages of tumor-associated B7-H1. Tumor-associated B7-H1 expression was significantly associated with a high frequency of postoperative recurrence and poor survival rate. Furthermore, multivariate analysis indicated that tumor-associated B7-H1 was more significant prognostic factor than WHO grade. CONCLUSIONS: Our results demonstrate that the aberrant expression of B7-H1 in urothelial cancer is associated with aggressive tumors, suggesting a regulatory role of tumor-associated B7-H1 in antitumor immunity. Therefore, the manipulation of tumor-associated B7-H1 may become a beneficial target for immunotherapy in human urothelial cancer.


Asunto(s)
Antígenos CD/análisis , Carcinoma de Células Transicionales/química , Proteínas de Neoplasias/análisis , Neoplasias de la Vejiga Urinaria/química , Antígenos CD/biosíntesis , Antígenos CD/genética , Antígenos CD/fisiología , Antígeno B7-H1 , Carcinoma de Células Transicionales/mortalidad , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/cirugía , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunofenotipificación , Neoplasias Renales/química , Neoplasias Renales/mortalidad , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Pelvis Renal/química , Pelvis Renal/patología , Pelvis Renal/cirugía , Linfocitos Infiltrantes de Tumor/inmunología , Linfocitos Infiltrantes de Tumor/patología , Masculino , Proteínas de Neoplasias/biosíntesis , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/fisiología , Recurrencia Local de Neoplasia , Pronóstico , Modelos de Riesgos Proporcionales , Análisis de Supervivencia , Neoplasias Ureterales/química , Neoplasias Ureterales/mortalidad , Neoplasias Ureterales/patología , Neoplasias Ureterales/cirugía , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía
12.
Int J Urol ; 13(12): 1475-8, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17118020

RESUMEN

OBJECTIVE: To evaluate lower urinary tract dysfunction of type 1 familial amyloidotic polyneuropathy (FAP) patients in Kumamoto, Japan. METHODS: Lower urinary tract symptoms were evaluated in FAP patients. Urodynamic studies were evaluated in FAP patients as compared to those in control subjects. The location and distribution of amyloid deposits were evaluated in the urinary bladder in an autopsy case. RESULTS: In lower urinary symptoms, 86%, 19% and 38% patients showed difficulty in urination, urinary frequency and urinary incontinence. In detrusor function during filling cystometry, 14% patients showed detrusor overactivity. Moreover, 43% patients showed low compliance bladder, 62% and 38% patients showed normal and reduced bladder sensation, respectively. First desire to void (FDV), strong desire to void (SDV) and post-voided residual urine (PVR) were increased in FAP patients as compared to those in control subjects. In the urethral pressure profilometry, 71%, 10% and 19% patients showed incompetent, normal functional and overactive urethral closure mechanism, respectively. Maximum urethral pressure (MUP), maximum urethral closure pressure (MUCP) and functional profile length (FPL) were decreased in FAP patients compared to those in control subjects. CONCLUSION: Autonomic, somatic nerve systems and bladder detrusor musculature might be impaired in lower urinary tract of type 1 FAP patients in Kumamoto, Japan.


Asunto(s)
Neuropatías Amiloides Familiares/complicaciones , Población Urbana , Vejiga Urinaria Hiperactiva/complicaciones , Incontinencia Urinaria/complicaciones , Retención Urinaria/complicaciones , Adulto , Neuropatías Amiloides Familiares/epidemiología , Femenino , Humanos , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Vejiga Urinaria Hiperactiva/epidemiología , Vejiga Urinaria Hiperactiva/fisiopatología , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/fisiopatología , Retención Urinaria/epidemiología , Retención Urinaria/fisiopatología , Urodinámica
13.
BJU Int ; 98(4): 794-7, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16978274

RESUMEN

OBJECTIVE: To determine the usefulness of prostate-specific antigen (PSA) screening for prostate cancer in patients with end-stage renal disease (ESRD), as although serum PSA is effective in the early detection of this cancer in the general population, there are few reports of its utility in patients with ESRD. PATIENTS AND METHODS: Blood samples were obtained for PSA screening from April 2002 to September 2003; 1250 men with ESRD aged >50 years were compared with 1007 healthy control men aged >55 years, all in Kumamoto Prefecture, Japan. All men with a serum PSA level of >4.0 ng/mL were categorized as PSA-positive and were further assessed, including a prostate biopsy. RESULTS: There was a statistically significantly greater increase in PSA level with age in the ESRD group than in the healthy controls. The rate of cancer detection among men with a PSA level of >10 ng/mL was significantly higher in patients with ESRD than in healthy controls. Thirteen patients with ESRD and five healthy control men were finally diagnosed with prostate cancer. CONCLUSION: The serum PSA level was slightly higher and the incidence of prostate cancer at higher PSA levels appeared to be greater in men with ESRD than in healthy controls. The findings of this large study suggest that PSA screening is useful for the diagnosis of prostate cancer in these patients.


Asunto(s)
Fallo Renal Crónico/complicaciones , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico , Anciano , Anciano de 80 o más Años , Humanos , Japón/epidemiología , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad
14.
Int J Urol ; 13(6): 811-3, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16834668

RESUMEN

A 67-year-old man received interferon alpha (IFN alpha) therapy for lung metastases of renal cell carcinoma (RCC). Multiple pulmonary metastases disappeared completely. However, neurological toxicity was detected by magnetic resonance imaging (MRI) as abnormal brain lesions. After discontinuation of IFN alpha therapy, his neurological symptoms and abnormal lesions on MRI disappeared completely. Complete remission of RCC has continued, and results of neurological study have remained normal for 5 years after discontinuation of IFN alpha therapy.


Asunto(s)
Interferón-alfa/efectos adversos , Neoplasias Renales/complicaciones , Neoplasias Pulmonares/complicaciones , Enfermedades del Sistema Nervioso/inducido químicamente , Anciano , Carcinoma de Células Renales , Humanos , Interferón-alfa/administración & dosificación , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/tratamiento farmacológico , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Masculino , Enfermedades del Sistema Nervioso/diagnóstico por imagen , Radiografía , Inducción de Remisión
15.
Int J Urol ; 13(3): 271-6, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16643622

RESUMEN

AIM: Recent studies have shown that various factors contribute to the increased excitability into the bladder afferent nerves in spinal cord injury (SCI) rats. It has been reported that prostaglandins (PG) act as local modulators of reflex micturition in pathological conditions. In the present study, we measured the amount of PGE2 release from the bladder of chronic SCI rats. METHODS: Spinal cord was transected at the level of T8-9 in adult female Sprague-Dawley rats. After 10 weeks, specimens of the urinary bladder were obtained from SCI rats and sham-injured control rats, and bladder strips were dissected from the bladder. Using an muscle-bath technique and a microdialysis procedure, the dialysate, containing substance released from bladder strips, was collected. Then the amount of PGE2 in the dialysate was measured by radioimmunoassay. RESULTS: Excretion of urinary PGE2 was significantly higher in SCI rats than in control rats. PGE2 release from bladder strips was significantly higher in SCI rats than in control rats. Removal of urothelium caused significant decreases in PGE2 release in both control and SCI rats. Stretches of the bladder strips caused significant resting tension-dependent increases in PGE2 release from the strips with urothelium. CONCLUSIONS: The present data suggest that bladder urothelium partly contributes to the increase in PGE2 release from the bladder, and that bladder distension may cause increases in PGE2 release in SCI rats.


Asunto(s)
Dinoprostona/metabolismo , Traumatismos de la Médula Espinal/metabolismo , Vejiga Urinaria/metabolismo , Animales , Biomarcadores/metabolismo , Modelos Animales de Enfermedad , Femenino , Estudios de Seguimiento , Técnicas In Vitro , Radioinmunoensayo , Ratas , Ratas Sprague-Dawley , Traumatismos de la Médula Espinal/complicaciones , Vejiga Urinaria/inervación , Vejiga Urinaria/patología , Incontinencia Urinaria/etiología , Incontinencia Urinaria/metabolismo , Incontinencia Urinaria/patología , Urotelio/metabolismo , Urotelio/patología
16.
Hinyokika Kiyo ; 51(10): 651-8, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16285617

RESUMEN

We report a multicenter trial with transrectal high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. A total of 72 consecutive patients with stage T1c-2NOM0 prostate cancer were treated using the Sonablate 500TM HIFU device (Focus Surgery, Indianapolis, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and prostate specific antigen (PSA) level were 72 years and 8.10 ng/ml, respectively. The median follow-up period for all patients was 14.0 months. Biochemical disease-free survival rates in all patients at 1 and 2 years were 78% and 76%, respectively. Biochemical disease-free survival rates in patients with stage T1c, T2a and T2b groups at 2 years were 89, 67% and 40% (p = 0.0817). Biochemical disease-free survival rates in patients with Gleason scores of 2-4, 5-7 and 8-10 at 2 years were 88, 72% and 80% (p = 0.6539). Biochemical disease-free survival rates in patients with serum PSA of less than 10 ng/ml and 10-20 ng/ml were 75% and 78% (p = 0.6152). No viable tumor cells were noted in 68% of patients by postoperative prostate needle biopsy. Prostatic volume was decreased from 24.2 ml to 14.0 ml at 6 months after HIFU (p < 0.01). No statistically significant differences were noted in International Prostate Symptom Score, maximum urinary flow rate and quality of life analysis with Functional Assessment of Cancer Therapy. HIFU therapy appears to be minimally invasive, efficacious and safe for patients with localized prostate cancer with pretreatment PSA levels less than 20 ng/ml.


Asunto(s)
Neoplasias de la Próstata/terapia , Ultrasonido Enfocado Transrectal de Alta Intensidad , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Tasa de Supervivencia , Resultado del Tratamiento
17.
J Recept Signal Transduct Res ; 25(3): 147-57, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16194931

RESUMEN

Previous studies have demonstrated that experimental type 1 diabetes induced by streptozotocin causes alterations in the biochemical and functional properties of several receptor systems in the rat bladder. However, the exact mechanism involved in the pathophysiology of voiding dysfunction in type 2 diabetic patients is unknown. Because the GK rat is a widely accepted genetically determined rodent model for human type 2 diabetes, we investigated diabetes-induced changes in the bladder smooth muscle of the GK rats at several time points. Male GK rats and age-matched Wistar rats, as controls, were maintained for 4, 8, 16, and 32 weeks. Contractile responses to KCl, carbachol, ATP, and electrical field stimulation (EFS) were measured by using the isolated muscle bath techniques. Acetylcholine (ACh) release induced by EFS from bladder muscle strips was measured by using high-performance liquid chromatography coupled with a microdialysis procedure. Maximum contractile responses to carbachol and ATP, the release of ACh, and tissue sorbitol levels were similar in bladders from GK and control rats until 8 weeks of age. At 16 weeks of age, however, the contractile responses to carbachol and ATP, and tissue sorbitol levels were increased, and the EFS-induced ACh release was decreased in GK rats compared with controls. Although the maximum contractile responses to EFS were unchanged until 16 weeks of age, they were decreased in 32-week-old GK rats, compared with controls. Our data indicate the presence of age-related alterations in the biochemical and functional properties of the bladder in type 2 diabetic GK rats.


Asunto(s)
Envejecimiento , Diabetes Mellitus Experimental/patología , Vejiga Urinaria/patología , Acetilcolina/metabolismo , Adenosina Trifosfato/metabolismo , Adenosina Trifosfato/farmacología , Animales , Peso Corporal , Carbacol/farmacología , Complicaciones de la Diabetes/patología , Diabetes Mellitus Tipo 2/patología , Electrofisiología , Glucosa/metabolismo , Insulina/metabolismo , Masculino , Contracción Muscular , Músculo Liso/citología , Músculos/patología , Cloruro de Potasio/farmacología , Ratas , Ratas Wistar , Nervio Ciático/metabolismo , Transducción de Señal , Sorbitol/metabolismo , Estreptozocina/farmacología , Factores de Tiempo , Vejiga Urinaria/efectos de los fármacos
18.
Int J Urol ; 11(11): 1001-8, 2004 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-15509205

RESUMEN

BACKGROUND: Muscarinic M3 (M3) receptor has been recognized as a major muscarinic receptor for smooth muscle contractions of the urinary bladder. Under the hypothesis that overexpression of M3 receptor in the urinary bladder would enhance urinary bladder contractions, we have transferred the M3 receptor gene into rat bladders using electroporation (EP) and evaluated the functional expression of the transferred gene. METHODS: Plasmids expressing luciferase, a green fluorescence protein and M3 receptor were injected into the rat bladder and square-wave electric pulses were immediately applied. Two days after gene transfer, we analyzed gene expression. Immunohistochemical staining was performed and the contractile responses from isolated bladder strips, which were induced KCl, carbachol and electrical field stimulation (EFS), were evaluated. RESULTS: The optimal conditions of electroporation were 8 pulses, 45 voltages, 50 milliseconds/pulses and 1 Hz. Under these conditions, luciferase gene expression was enhanced approximately 300-fold, compared to an injection of DNA only. Regarding immunohistochemistry with an anti-M3 receptor, an increase in immunoactivity was observed in the M3 receptor gene transferred rat bladder, compared to the bladder of the control rat. In rats with the transferred M3 receptor gene, carbachol- and EFS-induced maximum contractile responses of bladder smooth muscle strips significantly increased. CONCLUSIONS: These findings suggest that an in vivo EP procedure is an useful method for gene transfer into the bladder and that an overexpression of M3 receptor in the rat bladder enhances bladder contractility. This technique may become a new treatment modality for detrusor underactivity.


Asunto(s)
Electroporación , Técnicas de Transferencia de Gen , Receptor Muscarínico M3/genética , Receptor Muscarínico M3/metabolismo , Vejiga Urinaria/metabolismo , Animales , Carbacol/farmacología , Agonistas Colinérgicos/farmacología , Estimulación Eléctrica , Estudios de Factibilidad , Expresión Génica , Inmunohistoquímica , Técnicas In Vitro , Luciferasas/metabolismo , Masculino , Contracción Muscular/efectos de los fármacos , Contracción Muscular/fisiología , Músculo Liso/efectos de los fármacos , Músculo Liso/metabolismo , Ratas , Ratas Sprague-Dawley , Vejiga Urinaria/fisiopatología
19.
Urol Int ; 73(1): 74-80, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15263797

RESUMEN

INTRODUCTION: To investigate the mechanism of voiding dysfunction in non-insulin-dependent diabetes mellitus, we attempted to measure the acetylcholine (ACh) release using an in vivo microdialysis technique and measuring the detrusor pressure after electrical field stimulation (EFS) of the pelvic nerve. MATERIALS AND METHODS: Eight- and 32-week-old female Goto-Kakizaki (GK) rats (non-insulin-dependent diabetes mellitus model) and age-matched female Wistar rats (controls) were used in this study. The pelvic nerve was exposed on a bipolar platinum electrode to EFS, and a cannula was inserted into the bladder to measure the detrusor pressure. The microdialysis probe was inserted into the bladder wall and was connected to a microinfusion syringe pump. Dialysate was constantly perfused, collected in a microtube, and then injected into the ACh assay system. Histological examinations were performed by staining with hematoxylin and eosin and S-100 immunohistochemical staining in bladder preparations of both GK and control rats. RESULTS: In 8-week-old rats, both detrusor pressures and amounts of ACh release of GK rats were not significantly different from those of control rats. In 32-week-old rats, both detrusor pressures and ACh releases were only significantly increased at 5 and 10 Hz of EFS. In the histological study, the number of nerve fibers or bundles of 32-week-old GK rats was significantly decreased as compared with control rats. CONCLUSION: The present data suggest that the decrease in EFS-induced ACh release in GK rats, which may be caused by the decreased number of nerve fibers, may contribute to the decrease in bladder contractions.


Asunto(s)
Acetilcolina/metabolismo , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Músculo Liso/metabolismo , Vejiga Urinaria/metabolismo , Animales , Diabetes Mellitus Experimental/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Estimulación Eléctrica , Femenino , Músculo Liso/fisiopatología , Presión , Ratas , Ratas Wistar , Vejiga Urinaria/patología , Vejiga Urinaria/fisiopatología
20.
Urol Int ; 72(3): 257-60, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15084773

RESUMEN

We present a case of isolated renal tuberculosis following bacillus Calmette-Guérin (BCG) therapy for bladder cancer. In the presurgical radiographic examination, we suspected an atypical renal cell carcinoma. According to the diagnosis of renal cell carcinoma, we performed a radical nephrectomy. The histological findings were tuberculosis-specific inflammatory changes and the patient received an antituberculous multiple drug therapy for a year. It is concluded that we should pay attention to the possibility of a renal tuberculosis granuloma in any patient who presented with subacute formed renal masses following BCG treatment before deciding on the strategy of the treatment of the renal masses, especially in patients who had received such a treatment which induced an immunocompromised state.


Asunto(s)
Adyuvantes Inmunológicos/efectos adversos , Vacuna BCG/efectos adversos , Tuberculosis Renal/inducido químicamente , Adyuvantes Inmunológicos/administración & dosificación , Administración Intravesical , Anciano , Vacuna BCG/administración & dosificación , Humanos , Masculino , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico
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